Improving advanced intraoperative MRI methods during pediatric neurosurgery.

Autor: Jellema PEJ; Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.; Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, The Netherlands., Mannsdörfer LM; Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands., Visser F; Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, The Netherlands.; Philips HealthCare, Best, The Netherlands., De Luca A; Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, The Netherlands.; Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands., Smit CLE; Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands., Hoving EW; Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.; Department of Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands., van Baarsen KM; Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.; Department of Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands., Lindner T; Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany., Mutsaerts HMM; Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.; Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands., Dankbaar JW; Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Lequin MH; Department of Pediatric Neuro-Oncology, Princess Máxima Centre for Pediatric Oncology, Utrecht, The Netherlands.; Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Wijnen JP; Centre for Image Sciences, University Medical Centre Utrecht, Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: NMR in biomedicine [NMR Biomed] 2024 Jun; Vol. 37 (6), pp. e5124. Date of Electronic Publication: 2024 Feb 25.
DOI: 10.1002/nbm.5124
Abstrakt: Advanced intraoperative MR images (ioMRI) acquired during the resection of pediatric brain tumors could offer additional physiological information to preserve healthy tissue. With this work, we aimed to develop a protocol for ioMRI with increased sensitivity for arterial spin labeling (ASL) and diffusion MRI (dMRI), optimized for patient positioning regularly used in the pediatric neurosurgery setting. For ethical reasons, ASL images were acquired in healthy adult subjects that were imaged in the prone and supine position. After this, the ASL cerebral blood flow (CBF) was quantified and compared between both positions. To evaluate the impact of the RF coils setups on image quality, we compared different setups (two vs. four RF coils) by looking at T1-weighted (T1w) signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), as well as undertaking a qualitative evaluation of T1w, T2w, ASL, and dMR images. Mean ASL CBF did not differ between the surgical prone and supine positions in any of the investigated regions of interest or the whole brain. T1w SNR (gray matter: p = 0.016, 34% increase; white matter: p = 0.016, 32% increase) and CNR were higher (p = 0.016) in the four versus two RF coils setups (18.0 ± 1.8 vs. 13.9 ± 1.8). Qualitative evaluation of T1w, T2w, ASL, and dMR images resulted in acceptable to good image quality and did not differ statistically significantly between setups. Only the nonweighted diffusion image maps and corticospinal tract reconstructions yielded higher image quality and reduced susceptibility artifacts with four RF coils. Advanced ioMRI metrics were more precise with four RF coils as the standard deviation decreased. Taken together, we have investigated the practical use of advanced ioMRI during pediatric neurosurgery. We conclude that ASL CBF quantification in the surgical prone position is valid and that ASL and dMRI acquisition with two RF coils can be performed adequately for clinical use. With four versus two RF coils, the SNR of the images increases, and the sensitivity to artifacts reduces.
(© 2024 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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